Korean J Med.  2019 Feb;94(1):11-16. 10.3904/kjm.2019.94.1.11.

New Oral Agent for Treatment of Anemia in Patient with Chronic Kidney Disease: Prolyl Hydroxylase Inhibitor

• Na K

• KMID: 2438025
• DOI: http://doi.org/10.3904/kjm.2019.94.1.11

Abstract

Hypoxia inducible factor (HIF)-stabilizers are being developed for the renal anemia treatment. This small molecules inhibit prolyl hydroxylase domain (PHD)-containing enzymes, causing HIF activation instead of degradation under the state of normoxia, finally increase production of intrinsic erythropoiesis. Current treatment guidelines suggest that renal anemia should be treated mainly with iron and erythropoiesis stimulating agents (ESAs). But there are several complications and concerns such as hypertension, ESA refractory anemia and increased cardiovascular mortality in using ESAs. Advantages of HIF stabilizers over ESAs are orally available, no dose-up requirement for inflammation. So far new HIF stabilizers showed efficacy and safety in renal anemia treatment. This new therapeutic agent may emerge as a standard treatment option for renal anmia treatment.

Keyword

Prolyl hydroxylase inhibitor; Anemia; Hepcidin; ESA

MeSH Terms

Anemia*
Anemia, Refractory
Anoxia
Erythropoiesis
Hematinics
Hepcidins
Humans
Hypertension
Inflammation
Iron
Mortality
Prolyl Hydroxylases*
Renal Insufficiency, Chronic*
Hematinics
Iron